Youth with Disabilities at the Crossroads: The Intersection of Vocational Rehabilitation and Disability Benefits for Youth with Disabilities

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1 WORKING PAPER NUMBER: Youth with Disabilities at the Crossroads: The Intersection of Vocational Rehabilitation and Disability Benefits for Youth with Disabilities July 2014 Todd Honeycutt * Allison Thompkins Maura Bardos Steven Stern *Corresponding author s contact information: Mathematica Policy Research Post Office Box 2393 Princeton, NJ Telephone: (609) Reference Number: MPR13-05 The research reported herein was pursuant to a grant from the U.S. Social Security Administration (SSA) funded as part of the Disability Research Consortium (DRC). The findings and conclusions expressed are solely those of the author(s) and do not represent the views of SSA or any agency of the Federal Government. This draft paper is intended for review and comments only. It is not intended for citation, quotation, or other use in any form without the permission of the author(s).

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3 CONTENTS ABSTRACT... vii EXECUTIVE SUMMARY... ix I INTRODUCTION... 1 II BACKGROUND... 3 III METHODS... 7 A. Data Sources... 7 B. Measures... 8 C. Analytical Approach... 9 IV RESULTS A. To What Extent Do VR Youth Applicants with SSA Benefits Receive Services and Close with Employment? B. How Many VR Youth Applicants with SSA Benefits Go On to Have Suspension of Benefits Due to Work within Four Years of VR Application? C. How Many VR Youth Applicants without SSA Benefits at VR Application Receive SSA Benefits within Four Years After Applying for VR Services? D. How Do the Statistics for VR Youth with and without SSA Benefits Compare with Each Other and with State Characteristics? E. How Do Youth VR Applicants Who Receive SSA Benefits at Any Time Vary in Their Demographic and Service Characteristics from Those Who Have Never Received SSA Benefits? V CONCLUSION REFERENCES APPENDIX A iii

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5 TABLES 1 VR Youth Applicants (Three-Year Average) Transition Ratios of VR Youth Applicants with and Without SSA Benefits (Three-Year Average) SSA VR Applicants with Suspension of Benefits Due to Work (Three-Year Totals) Non-SSA VR Youth Applicants Who Receive SSA Benefits Within 72 Months of VR Application (Three-Year Totals) Correlation Matrix of SSA Transition Ratios with Other Ratios and Characteristics Mean SSA Transition Ratios by OOS Status Demographic and Service Characteristics of VR Applicants (Percentage Unless Otherwise Indicated) v

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7 ABSTRACT State vocational rehabilitation (VR) agencies are well positioned to assist youth and young adults (ages 16 to 24) with disabilities who are transitioning from school to work and facing issues related to Social Security Administration (SSA) benefit receipt. Using RSA-911 records matched to SSA administrative records, this paper adds to the knowledge about state VR agency provision of services to youth with disabilities and differences in outcomes based on SSA benefit receipt status. Though agencies statistics varied widely, almost one in six SSA beneficiaries who sought VR services had at least one month of benefit suspension due to work within 48 months of their VR applications, and about one in 10 VR applicants without SSA benefits at the time of their VR application received SSA benefits within 48 months. While SSA beneficiaries received services from VR agencies at the same level as non-ssa beneficiaries, the levels at which they were employed when they closed from services was lower. The results have two main policy implications. First, the level of resources to which agencies have access may be important in influencing the outcomes we measured. Second, agency differences in the proportion of SSA beneficiaries who eventually had benefit suspension due to work point to the potential for additional gains by agencies in this area. These factors, along with the potential for long-term benefits for youth, could justify further investment in VR agencies by the federal government in promoting service delivery to transition-age youth. vii

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9 EXECUTIVE SUMMARY State vocational rehabilitation (VR) agencies are well positioned to assist youth and young adults (ages 16 to 24) with disabilities who are transitioning from school to work and facing issues related to Social Security Administration (SSA) benefit receipt. This paper adds to the knowledge about state VR agencies provision of services to youth with disabilities and differences in outcomes based on SSA benefit receipt status. We used data from the Rehabilitation Services Administration (RSA)-911 Case Study Report matched to SSA administrative records. This study addresses the following questions: To what extent do VR youth applicants with SSA benefits receive services and close with employment? How many VR youth applicants with SSA benefits go on to have their benefits suspended due to work within four years of VR application? How many VR youth applicants without SSA benefits at VR application receive SSA benefits within four years after applying for VR services? How do the statistics for VR youth with and without SSA benefits compare with each other and with state characteristics? How do youth VR applicants who receive SSA benefits at any time vary in their demographic and service characteristics from those who have never received SSA benefits? The primary focus of our analysis is the intersection between VR agencies and SSA disability benefit programs. We calculated six measures to assess this intersection five that reflected service provision to SSA VR applicants and one that reflected the extent to which nonbeneficiary youth eventually receive SSA benefits. Our key findings, organized by measure, follow. 1. SSA VR applicants (the proportion of a state s VR applicant pool that received federal disability benefits (Supplemental Security Income [SSI] or Social Security Disability Insurance [SSDI]) at application). The proportion of transition-age VR applicants with SSA benefits averaged 22 percent across agencies, ranging from 11 percent in North Dakota to 38 percent in Washington State. Most SSA VR youth (76 percent) received SSI-only benefits, with the remaining SSA VR youth divided equally between SSDI-only and concurrent benefits. 2. SSA service-to-applicant ratio (the ratio of SSA youth who received VR services to SSA youth who applied). On average, 57 percent of transition-age SSA beneficiaries who applied for VR services eventually received them. This proportion is very close to the service-toapplicant ratio for non-ssa VR applicants (55 percent). VR agencies had a wide range for the service-to-applicant ratio 46 percentage points between the agencies with the lowest and highest statistics. 3. SSA employment-to-service ratio (the ratio of SSA youth with positive employment outcomes to SSA youth who received services). On average, 44 percent of transition-age SSA beneficiaries who applied for and received VR services were employed at the time of ix

10 EXECUTIVE SUMMARY MATHEMATICA POLICY RESEARCH case closure, compared with 59 percent for youth not receiving SSA benefits. Wyoming s VR agency had the highest SSA employment-to-service ratio; 62 percent of SSA VR youth who received services exited with employment. On the low end, SSA VR applicants receiving VR services in Oklahoma achieved positive employment outcomes 26 percent of the time. 4. SSA employment-to-applicant ratio (the product of the SSA service-to-applicant and employment-to-service ratios). About 25 percent of youth receiving SSA benefits who applied to VR received services and were employed when they closed from services; the comparable number for non-ssa VR youth applicants was 33 percent. Delaware and Utah had the highest ratios (41 percent), whereas the agencies in Illinois, Iowa, Louisiana, and Maine had the lowest values (all less than 17 percent). 5. SSA VR youth applicants with benefit suspension (the proportion of SSA VR youth who had any suspension or termination of benefits due to work after 48 months from VR application). Almost one in six SSA beneficiaries who sought VR services (14 percent) had at least one month of benefit suspension due to work within 48 months of their VR applications. Agencies differed in their benefit suspension outcomes by as much as 16 percentage points. 6. Non-SSA VR applicants who obtain SSA benefits (the proportion of VR applicants not receiving benefits at the time of VR application who received SSI, SSDI, or concurrent benefits at 24 and 48 months after application). About one in 10 VR applicants without SSA benefits at the time of VR application (10 percent) received SSA benefits within 48 months. Agencies had sizeable variation in the percentage of non-ssa VR youth applicants who received SSA benefits within 48 months of application, from 4 percent (South Carolina) to 21 percent (Washington State). The range in ratios across agencies for these measures underscores the need to examine state-level variation in agency processes and outcomes, rather than examining statistics in aggregate. The SSA service-to-applicant, employment-to-service, and employment-to-applicant ratios were highly and positively correlated with the same ratios for non-ssa VR applicants, suggesting that the patterns of processes and outcomes are similar for all VR applicants, even if the values of the ratios differ. Further analysis identified that agencies with more resources had better employment outcomes for the SSA youth they served, had higher proportions of SSA youth with benefit cessation, and had fewer non-ssa youth eventually receiving benefits. The issue of resources might be even more critical when considering that the expenditures we observe for SSA VR youth might be higher than the expenditures for VR youth without benefits. Overall, these findings suggest that VR agencies can potentially serve as early intervention programs, providing the services that youth with disabilities need to work and help avoid dependence on SSA benefits, and that some agencies might be better positioned for this task than others. The level of resources to which agencies have access could be important in influencing the outcomes measured. Agency differences in the proportion of SSA beneficiaries who eventually had benefit suspension due to work also point to the potential for additional gains by agencies in this area. These factors, along with the potential for long-term benefits for youth, could justify further investment in VR agencies by the federal government in promoting service delivery to transition-age youth. x

11 I. INTRODUCTION State vocational rehabilitation (VR) agencies are well positioned to assist youth and young adults (ages 16 to 24) with disabilities who are at a transition crossroads, moving from school to work and facing different issues related to Social Security Administration (SSA) disability benefit receipt. VR agencies can help individuals attain their vocational goals by offering specific vocational training, soft skill development, assistance with job search activities, and financing and other supports for higher education. Effective VR services can help young adults avoid the need to seek disability benefits, and help those who do receive benefits become more self-sufficient. Young adults with disabilities who receive disability benefits are typically at a greater economic disadvantage than those not receiving disability benefits. As a result of this and disparate economic incentives, it is likely that VR outcomes for youth with disabilities vary according to disability benefits receipt status. This paper adds to the knowledge about state VR agency provision of services to youth with disabilities and differential outcomes according to disability benefit receipt status. We do this by presenting new statistics on the SSA outcomes for youth with and without disability benefits who apply for VR services. The statistics were obtained by merging RSA-911 closure data across several years with the SSA s Disability Analysis File (DAF) and are presented in state-level form as well as in aggregate form. The study answers the following questions: To what extent do VR youth applicants with SSA benefits receive services and close with employment? How many VR youth applicants with SSA benefits go on to have suspension of benefits due to work within four years of VR application? How many VR youth applicants without SSA benefits at VR application receive SSA benefits within four years after applying for VR services? How do the statistics for VR youth with and without SSA benefits compare with each other and with state characteristics? How do youth VR applicants who receive SSA benefits at any time vary in their demographic and service characteristics from those who have never received SSA benefits? In the next section, we present background information regarding the use of VR and disability benefits by transition-age youth with disabilities. In Section III, we provide details about the data, measures, and methods used. Answers to the study s research questions comprise Section IV. And in the final section, we conclude with implications for policymakers and suggestions for future research. 1

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13 II. BACKGROUND VR agencies are joint federal-state programs that aid those eligible for rehabilitation services in attaining employment. VR agencies have some latitude in determining the services they provide and the clientele they serve, resulting in state-level variation in VR program services, staffing, and expertise for youth with disabilities. Many agencies have recognized the special needs of youth and have focused their efforts on easing the transition from school to work or postsecondary education. Agency staff often participate in secondary school transition planning for students receiving services under the Individuals with Disabilities Education Act (IDEA). For eligible youth who initiate the process, VR staff develop a service plan aimed at achieving competitive, paid employment and service provision to help individuals attain their vocational goals. Individual agencies, though, differ in the types of services they provide for youth (Honeycutt et al. 2014; The Study Group, Inc. 2007). VR agencies vary substantially in the way they serve youth with disabilities. On a national basis, the average number of individuals with disabilities, ages 14 to 24, who exited VR was about twice that of their older working-age peers, a statistic that reflects the strong focus of the VR system on the younger population (Stapleton et al. 2010). This study also shows that agencies vary greatly in the extent to which they serve youth: the proportion of individuals with disabilities in this age range who received services varied sevenfold across states. Honeycutt et al. (forthcoming) confirm differences in how agencies serve youth, from application to service delivery to closure status. On average, 8 percent of youth with disabilities, ages 16 to 24, applied to a VR agency, 56 percent of applicants received services, and 56 percent of those served were employed when they closed from VR after receiving services. However, behind these averages lies substantial variation across VR agencies as much as 50 percentage points between the agencies with the highest and lowest statistics. Young adults with SSA disability benefits are of special concern to policymakers in a broad sense and to VR agency staff in a more specific way. Youth with disabilities are eligible to receive disability benefits, either from Supplemental Security Income (SSI) (a means-tested program) or from Social Security Disability Insurance (SSDI) when they meet medical eligibility criteria, common to both programs. In addition, SSI eligibility depends on a means test and SSDI eligibility depends on earnings history. Many youth receiving SSDI at this age receive benefits as Disabled Adult Children (DAC), meaning that they receive benefits because they have a disability that began before age 22 and their parents receive Social Security retirement or disability benefits or their parents died. These youth receive their Social Security Disability benefits through their parents earnings record (SSA 2013b). Many of these youth qualified for special education services under IDEA. While the employment outcomes and engagement in productive activities (such as school enrollment) for youth with disabilities are typically below those of youth without disabilities, they are even lower for youth with SSA benefits (Hemmeter et al. 2009; Loprest and Wittenburg 2007). Further, the potential loss of some or all SSA benefits may discourage young beneficiaries from attempting to work, but the benefits themselves and other services available to beneficiaries may facilitate their return-to-work efforts. The potential benefits for youth leaving the benefit rolls, or not obtaining benefits to begin with, are large for both youth and the federal government, as earnings and the savings in cash and health benefits can compound over a lifetime. As a component of the SSA programs, individuals have access to incentives that encourage work, such as VR services through state vocational rehabilitation agencies or employment networks and expedited reinstatement for individuals who leave the 3

14 II. BACKGROUND MATHEMATICA POLICY RESEARCH rolls due to work but encounter health difficulties that prevent them from working within five years of benefit suspension (SSA 2013a). The rules for benefit suspension, particularly due to earnings, vary by benefit type. Individuals whose medical condition improves can lose their benefits, no matter the type. Upon reaching age 18, child SSI recipients must successfully undergo a redetermination of eligibility based on the adult definition of disability to continue receiving cash assistance. If they do not meet the medical criteria for adults (having a condition that limits or prevents substantial gainful activity [SGA]), their income and health supports are terminated, along with their access to other programs that require disability benefit receipt for eligibility. SSI recipients who work and earn income above a low threshold generally lose $1 of benefits for every $2 of earnings. SSDI earnings rules are less restrictive if earnings are below the SGA amount ($1,040 a month for non-blind beneficiaries and $1,740 for blind beneficiaries in 2013); full benefits are paid indefinitely. If earnings are higher, however, the SSDI rules are more restrictive, except during a trial work period (TWP) consisting of 9 months during a 60-month period and an additional 3- month grace period. Cash benefits for SSDI beneficiaries cease completely if earnings exceed the SGA amount. During the 36 months after the TWP, benefits are reinstated in months when earnings fall below the SGA amount, but after that, benefits can only be reinstated through a formal reinstatement process. SSA youth are an important focus of VR agencies for three reasons. First, beneficiaries represent a large subgroup of individuals seeking VR services. Second, agencies can receive reimbursements from SSA for services they provide to SSA beneficiaries with successful employment outcomes (O Day and Revell 2007). These reimbursements are an additional source of income for agencies and perhaps more likely for the transition-age population, given that younger SSA beneficiaries are more likely to have employment outcomes than older SSA beneficiaries (for example, Livermore et al. [2013]). Third, VR services can influence SSA receipt because VR agencies are well positioned to provide necessary services at a critical juncture, the crossroads of youths transitions from school to work. For beneficiaries, youth can receive the supports and training they need to obtain gainful employment and reduce or cease receiving cash benefits. For non-beneficiaries, VR agencies can potentially be a diversion program, leading youth with disabilities toward gainful employment and away from benefit receipt. For youth who meet the SSA medical criteria but not the earnings criteria for SSDI, VR agencies potentially can help youth make enough money to meet the earnings history criteria for SSDI, but not earn more than the SGA amount, which makes them ineligible for SSDI. The latter might be particularly important for youth who already receive SSI, and therefore meet the medical eligibility criteria. Typically, their new SSDI benefits will be low and offset by an SSI reduction, but their benefits will not be reduced by earnings if such earnings are less than the SGA amount. Thus, youth in such circumstances will eventually become eligible for Medicare. If these youth receive Medicaid, Medicare eligibility will not necessarily be helpful, but it will reduce state expenditures for Medicaid on behalf of these youth because Medicare will become first payer. Despite this interest, few studies have focused on understanding the relationship between VR and disability benefit receipt for transition-age youth. Evidence from a survey of current and former SSI recipients ages 19 to 23 suggests that fewer than about one in 7 had ever received services from a VR agency, but those involved with VR were no more or less likely to be employed (Loprest and Wittenburg 2007). Evidence from the Youth Transition Demonstration, a 4

15 II. BACKGROUND MATHEMATICA POLICY RESEARCH study of youth receiving or at risk of receiving SSA benefits, found that no more than 14 percent of SSI youth received services from a VR agency in the course of a year (Honeycutt and Wittenburg forthcoming). In a separate study, SSI youth who received supported employment services through VR were more likely to be employed two years after completing services, while SSI youth who received education services through VR were less likely to be employed but had higher earnings up to five years after completing VR services (Berry and Caplan 2010). The latter study also identified state contextual factors the poverty rate and the agency consumer-tocounselor ratio as influential to outcomes for youth SSI beneficiaries. More broadly, other studies have found negative relationships between SSA benefit receipt (or public income support) and employment outcomes for youth (for example, Giesen and Cavanaugh 2012; Gonzales et al. 2011), which is consistent with the greater body of literature on the relationship between benefit receipt and outcomes for adults. The current study addresses the gaps in the literature by identifying the rates at which VR applicants with SSA benefits (SSA VR applicants) eventually have any benefit suspension due to work. It also presents information on the rate at which VR applicants without SSA benefits (non- SSA VR applicants) eventually obtain SSA benefits. We present this information both in aggregate and at the state level. 5

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17 III. METHODS A. Data Sources For this study, we used RSA-911 Case Service Report data for federal fiscal years 2004 through 2011 and SSA s DAF to develop application and closure cohort files for youth and young adults who applied for VR services in fiscal years 2004, 2005, and The RSA-911 data contain information about each person who exited VR services during the year, such as demographic characteristics at the time of application, types of services received, and employment outcomes for those who received services. States provide data on case closures by November for the previous fiscal year to RSA, which in turn releases the data to researchers annually. The DAF contains a longitudinal record for every person age 10 through the Social Security full retirement age (currently age 66) who received Social Security or SSI disability benefits at any time from 1996 onward; at the time of our analysis, it contained data through By matching these data to RSA-911 records, we were able to identify which VR youth applicants received benefits at the time they applied for VR services or within 48 months of their VR applications. Some individuals may have received benefit awards or changes in the final year of the DAF that are not reflected in the file (for instance, the award may have occurred in 2012 and been retroactive to the previous year). Therefore, we restrict our analysis to examine outcomes up to four years after VR application (or through 2010 for the 2006 VR applicant cohort). We defined receipt of benefits at application as being in current pay status and as receiving a positive cash benefit within two months before or after the month of application. For the purpose of this study, we defined the transition-age youth population as those ages 16 through 24 at the time they applied for VR services. We specified 24 years as the upper age limit to align with the definition of the working-age population (typically ages 25 to 64) and 16 years as the lower age limit to align with IDEA legislation on when secondary-school staff establish a transition plan. Only youth who had applied to VR agencies that serve the 50 states and the District of Columbia were included in the analysis. We excluded applicants to agencies that exclusively serve blind individuals (approximately 3 percent of all closures). Further, our sample includes only individuals who were alive at the time of case closure and, because individuals could have multiple case records (reflecting multiple VR applications in 2004, 2005, and 2006), we limited the sample to only one record per individual, dropping all case records for an individual after the earliest observation. 1 To develop annual applicant cohorts to be followed from application to case closure and beyond, we realigned the data to include only youth who applied for VR services in fiscal years 2004, 2005, and This realignment allows sufficient time through 2011 (five to seven years) to observe their completion of VR services. It has the added value of comparing the experiences of youth who applied at about the same time, thereby controlling for local, state, and agency factors that could vary for individuals who close at the same time (most notably for those who close with and without receiving VR services). 1 This latter restriction differs from the method used in Honeycutt et al. (2013), resulting in smaller sample sizes of VR applicants for the current study. 7

18 III. METHODS MATHEMATICA POLICY RESEARCH B. Measures Transition-age youth measures. The primary focus of our analysis is the intersection between VR agencies and SSA disability benefit programs. We calculate six measures to assess this intersection, five that reflect service provision to SSA VR applicants, and one that reflects the extent to which non-beneficiary youth eventually receive SSA benefits. 1. SSA VR applicants. From the matched RSA-911 and DAF, we identify the number of youth who received SSI, SSDI, or both at the time they applied for VR services. We present this group in various ways: as an aggregate measure for the three applicant cohorts (that is, the total number of such youth across all three applicant years); as an average across the three applicant cohorts (indicating an annual average); and as a proportion of all VR youth applicants. 2. SSA service-to-applicant ratio (ratio of SSA youth who received VR services to SSA youth who applied). We calculate the SSA service-to-applicant ratio as the number of SSA VR youth who received VR services divided by the number who applied for VR services. The numerator includes SSA youth who were assessed as eligible, completed an individualized plan for employment (IPE), and eventually received services from the agency. 3. SSA employment-to-service ratio (ratio of SSA youth with positive employment outcomes to SSA youth who received services). The third ratio uses a similar approach as the SSA service-to-applicant ratio; the number of SSA VR youth who closed from VR with a positive employment outcome divided by the number of such youth who received services. The denominator is the same as the numerator for the service-to-applicant ratio; the numerator is the subset of that population of youth who closed from services with employment (as opposed to those not employed at closure after receiving services). Note, though, that this does not capture youth who obtained jobs without obtaining services, either before or after closure; their cases were closed in a different status and their employment is not captured in their VR records. 4. SSA employment-to-applicant ratio. We calculate a summary ratio as the product of the SSA service-to-applicant and employment-to-service ratios. This statistic shows the level at which SSA VR applicants received services and closed with an employment outcome. 5. SSA VR youth applicants with benefit suspension. For all SSA VR youth applicants, we use data from the DAF to measure the proportion of youth who had any suspension or termination of benefits due to work after their VR application (benefit suspension). We exclude from the numerator youth whose benefits terminate for other reasons, such as a rejection for medical improvement or based on an age-18 redetermination. We present this statistic at two points in time after VR application (at 24 and 48 months), and supplement this proportion with the average number of months without SSI or SSDI benefits for the 48- month period after VR application. 6. Non-SSA VR applicants who obtain SSA benefits. Based on data elements in the DAF, we calculate the proportion of VR applicants not receiving benefits at the time of VR application who received SSI, SSDI, or concurrent benefits at 24 and 48 months after application. To improve our understanding of these ratios, we calculate correlations between these ratios and between the ratios and additional state measures. These state measures include the service- 8

19 III. METHODS MATHEMATICA POLICY RESEARCH to-applicant, employment-to-service, and employment-to-applicant ratios calculated for non-ssa VR applicants, as well as state characteristics that were found to be significant to the transition ratios (Honeycutt et al. forthcoming). The measures and the sources from which measures were drawn are as follows: Number of transition-age youth (American Community Survey or ACS) Percentage of transition-age youth with a disability (ACS) Mean cost of purchased services per youth served (RSA-911 records) VR grant allotment per working-age person with a disability (GAO 2009) Annual state unemployment rate (Current Population Survey) Youth labor force participation rate (ACS) Mean SSA transition ratios according to an agency s order of selection (OOS) status (as indicated in RSA-113 records, which are cumulative case reports from VR agencies). Details about each of these measures can be found in Honeycutt et al. (forthcoming). In addition to the above, we also present various demographic and agency characteristics for specific categories of VR youth applicants: non-ssa VR applicants who do and do not obtain benefits within 48 months of VR application and SSA VR applicants who do and do not have benefit suspension by 48 months (by disability benefit type). We include the following characteristics from the RSA-911 data: gender, age at application, race, educational status at application, individualized education plan (IEP) status, disability cause, VR eligibility status, VR service receipt status, employed at VR case closure after receiving services, service receipt (diagnosis and evaluation, training, employment, post-secondary education, restoration, maintenance, and other), and purchased service cost. C. Analytical Approach We rely on descriptive analyses to explore the variation in how VR agencies work with SSA youth. For each of the measures, we present agency-specific values on the range across agencies and the agencies with relatively high or low values for these ratios. For demographic variable analyses, we compare the differences between specific VR groups using t-tests, adjusting for significance using a Bonferroni correction for multiple comparisons. A final analytical approach compares agency- and state-level factors with the SSA transition ratios using Pearson correlation coefficients statistical tests where applicable. Given the small sample size (51 states), this analysis is exploratory in nature, and the results are presented to inform future research. 9

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21 IV. RESULTS A. To What Extent Do VR Youth Applicants with SSA Benefits Receive Services and Close with Employment? We present statistics for the measures of SSA and non-ssa VR youth in Tables 1 and 2 and discuss our findings for each below. An appendix table presents supplemental statistics for SSA youth, including the number of youth with SSA benefits in each state. SSA VR applicants. In Table 1, we present both the count and proportion of youth VR applicants who received SSA benefits at the time of application. Each year over the period from 2004 through 2006, nearly 30,000 youth receiving SSA benefits applied for VR services. These youth accounted for 21 percent of all transition-age youth applicants to VR per year. The proportion of a state s VR applicant pool that received federal disability benefits (SSI or SSDI) at application ranged from 11 percent in North Dakota to 38 percent in Washington State, with the latter value being an outlier. Connecticut had the next highest value at 30 percent. A possible source of variation in this statistic is resource limitations, as agencies in OOS may serve more SSA beneficiaries because they can only provide services for applicants with more significant disabilities, a category that most SSA beneficiaries fall into, and perhaps discourage individuals with less severe disabilities from applying. This issue may explain the high value for Washington State, which was in OOS during the observation period. The variation across agencies may also reflect the level and nature of outreach by the agency to youth with disabilities, and may also be influenced by state demographics, as some states contain a higher concentration of youth SSA beneficiaries than others. The number of youth receiving SSA benefits at application can be decomposed by program participation: SSI-only beneficiaries, SSDI-only beneficiaries, and those receiving both benefits (concurrent beneficiaries) (not shown). As expected, given the relatively low opportunities for employment, most SSA VR youth (76 percent) received SSI-only benefits. The remaining SSA VR youth were divided equally between SSDI-only and concurrent benefits. SSA service-to-applicant ratio. Across the United States, 57 percent of transition-age SSA beneficiaries who applied for VR services eventually received them (Table 2). This proportion is very close to the service-to-applicant ratio for non-ssa VR applicants (55 percent). We expected the ratio for SSA VR youth to be higher because most are assumed to be eligible for VR services. This statistic reflects eligibility as well as IPE development and actual service receipt. As we show later, SSA VR youth typically had higher eligibility rates; the lower-than-expected value may represent additional barriers that SSA youth may encounter regarding employment relative to other youth (such as having more severe disabilities, accessing services, and setting appropriate vocational goals), or perhaps reservation wage effects associated with SSA benefit receipt. Unobserved factors on the part of agency staff may also influence service receipt for this population. VR agencies had a wide range for the service-to-applicant ratio 46 percentage points between the agencies with the lowest and highest statistics. At one end of the spectrum, over 70 percent of youth with benefits in Alabama, Georgia, Oklahoma, Pennsylvania, and Virginia who applied for services received them. At the other end of the spectrum, fewer than 40 percent of youth with benefits in Illinois, Iowa, Maine, Minnesota, and Missouri received such benefits. We 11

22 IV. RESULTS MATHEMATICA POLICY RESEARCH Table 1. VR Youth Applicants (Three-Year Average) SSA VR Youth State Youth with Disabilities (ACS) VR Applicants Ages 16 to 24 Applied Received Services Closed with Employment Percentage of Youth VR Applicants with SSA Benefits Alabama 47,912 4, Alaska 7, Arizona 39,509 1, Arkansas 29,065 2, California 238,955 9,568 2,156 1, Colorado 35,123 1, Connecticut 20, Delaware 7, District of Columbia 4, Florida 118,834 6,458 1, Georgia 68,208 4, Hawaii 6, Idaho 14,258 1, Illinois 79,171 5,971 1, Indiana 52,681 2, Iowa 22,270 2, Kansas 24,790 1, Kentucky 44,629 3, Louisiana 46,377 2, Maine 13, Maryland 38,661 2, Massachusetts 47,230 2, Michigan 93,909 5, Minnesota 37,595 2, Mississippi 30,208 1, Missouri 53,781 4, Montana 8, Nebraska 15,318 1, Nevada 12, New Hampshire 10, New Jersey 53,281 3, New Mexico 17,758 1, New York 136,039 9,853 2,046 1, North Carolina 65,815 6,009 1, North Dakota 6, Ohio 97,625 3, Oklahoma 35,630 2, Oregon 33,009 1, Pennsylvania 98,566 6,773 1,505 1, Rhode Island 9, South Carolina 39,531 3, South Dakota 6, Tennessee 54,004 3, Texas 188,442 8,590 1, Utah 21,121 1, Vermont 8, Virginia 55,600 2, Washington 60,755 1, West Virginia 17,230 1, Wisconsin 47,697 2, Wyoming 4, Total 2,326, ,762 29,330 16,753 7, Median 35,630 2, Minimum 4, Maximum 238,955 2,071 2,156 1, Sources: RSA-911 closure records, fiscal years 2004 through 2011; ACS ; DAF Note: Data show three-year averages of youth with disabilities, VR applicants ages 16 to 24, and SSA VR applicants. 12

23 IV. RESULTS MATHEMATICA POLICY RESEARCH Table 2. Transition Ratios of VR Youth Applicants with and Without SSA Benefits (Three-Year Average) SSA VR Applicants Non-SSA VR Applicants State SSA Service- to- Applicant Ratio SSA Employment -to-service Ratio SSA Employmentto-Applicant Ratio Non-SSA Service-to- Applicant Ratio Non-SSA Employment -to-service Ratio Non-SSA Employment -to- Applicant Ratio Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Total Median Minimum Maximum

24 IV. RESULTS MATHEMATICA POLICY RESEARCH Sources: RSA-911 closure records, fiscal years 2004 through 2011; ACS ; DAF Note: N = 413,285. Data show three-year averages of VR applicants with and without SSA benefits at application. Service-toapplicant ratio is the number of youth ages 16 to 24 who received services from a VR agency relative to the number of applicants ages 16 to 24. Employment-to-service ratio is the number of youth ages 16 to 24 who closed from VR with employment outcomes relative to the number who received services. Employment-to-applicant ratio is the product of the service-to-applicant and employment-to-service ratios. We present these ratios for SSA VR applicants and non-ssa VR applicants. 14

25 IV. RESULTS MATHEMATICA POLICY RESEARCH observe a slightly larger range (58 percentage points) across states on the ratios calculated for non-ssa VR applicants. SSA employment-to-service ratio. Nationally, 44 percent of transition-age SSA beneficiaries who applied for and received VR services were employed at the time of case closure. In comparison, nationally, of all non-ssa VR youth who applied from 2004 to 2006 and received services, 59 percent exited from services and were employed at the time. In other words, SSA youth receiving VR services were employed at closure at rates that were 15 percentage points lower than observed for all youth served by VR at case closure. The VR agency in Wyoming had the highest SSA employment-to-service ratio; 62 percent of SSA VR youth who received services exited with employment. The Wyoming agency was closely followed by agencies in Alaska, Delaware, Maryland, and Utah, all of whose statistics were around 60 percent. On the low end, SSA VR applicants receiving VR services in Oklahoma were successful at achieving positive employment outcomes 26 percent of the time. The employment-to-service ratio focuses on the proportion of applicants who received services and whose cases were closed with employment outcomes. However, of course, employment outcomes can be influenced by economic and other conditions in the states, as well as by agency and demographic factors. The range in the employment-to-service ratios for non-ssa VR applicants was slightly smaller than for SSA VR applicants (31 percentage points to 35 percentage points). SSA employment-to-applicant ratio. Nationally, 25 percent of youth receiving SSA benefits who applied to VR received services and were employed when they closed from services (Table 2). This aggregate measure is the product of the two previously discussed transition ratios. The comparable number for non-ssa VR youth applicants was 33 percent; the likelihood of applicants receiving services and employed at closure was therefore 8 percentage points greater for non-ssa VR youth applicants than for SSA VR youth applicants. Delaware and Utah had the highest statistics (41 percent), followed by Alabama, Vermont, Alaska, Wyoming and North Dakota. Among SSA beneficiaries who applied for VR services in these states, between 35 and 41 percent exited with an employment outcome. In contrast, the agencies in Illinois, Iowa, Louisiana, and Maine, had the lowest values (all less than 17 percent). No more than 17 percent of VR youth applicants with SSA benefits in those states received services and exited with a positive employment outcome. B. How Many VR Youth Applicants with SSA Benefits Go On to Have Suspension of Benefits Due to Work within Four Years of VR Application? In Table 3, we show the percent of SSA VR applicants who experienced benefit suspension within 24 and 48 months of their VR application. Over the 48-month follow-up period, the proportion of SSA VR applicants who experienced a suspension of benefits increased. Within 24 months after VR application, 7.9 percent of SSA VR applicants experienced benefit suspension; at 48 months, this proportion almost doubled to 14.2 percent. There was variation in time off the rolls by benefit type. On average, VR youth with SSI or concurrent benefits had higher rates of benefit suspension within 48 months (13 percent and 26 percent, respectively), relative to SSDI beneficiaries (6 percent) (data not shown). 15

26 IV. RESULTS MATHEMATICA POLICY RESEARCH Table 3. SSA VR Applicants with Suspension of Benefits Due to Work (Three- Year Totals) SSA VR Applicants (N) Benefit Suspension Due to Work Within 24 Months (%) Benefit Suspension Due to Work Within 48 Months (%) Alabama 2, Alaska Arizona 1, Arkansas 1, California 6, Colorado Connecticut Delaware District of Columbia Florida 4, Georgia 2, Hawaii Idaho Illinois 3, Indiana 1, Iowa 1, Kansas Kentucky 2, Louisiana 1, Maine Maryland 2, Massachusetts 1, Michigan 2, Minnesota 1, Mississippi 1, Missouri 2, Montana Nebraska Nevada New Hampshire New Jersey 2, New Mexico New York 6, North Carolina 4, North Dakota Ohio 2, Oklahoma 1, Oregon 1, Pennsylvania 4, Rhode Island South Carolina 1, South Dakota Tennessee 2, Texas 4, Utah Vermont Virginia 2, Washington 2, West Virginia Wisconsin 2, Wyoming Total or mean 87, Median 1, Minimum Maximum 6, Sources: RSA-911 closure records, fiscal years 2004 through 2011; DAF 16

27 IV. RESULTS MATHEMATICA POLICY RESEARCH Note: Data show three-year totals of VR SSA applicants ages 16 to 24, the proportion with benefit cessation due to work within 48 months, and the average number of months with benefit cessation within 48 months for those receiving SSI or SSDI benefits. 17

28 IV. RESULTS MATHEMATICA POLICY RESEARCH Agencies differed in their benefit suspension outcomes by as much as 16 percentage points. In eight agencies (Alaska, Arizona, District of Columbia, Massachusetts, Nebraska, Nevada, North Dakota, and Wyoming), more than one-fifth of their SSA VR applicants experienced benefit suspension due to work within 48 months of VR application. In contrast, the agencies in Kentucky, North Carolina, Tennessee, and West Virginia had no more than 10 percent of their SSA VR applicants with any benefit suspension within 48 months. The agencies with the lowest values are all located in the South. C. How Many VR Youth Applicants without SSA Benefits at VR Application Receive SSA Benefits within Four Years After Applying for VR Services? Across the United States, on average, 10 percent of transition-age youth who applied for VR and did not have SSA benefits at the time of their application began receiving either SSI or SSDI within 48 months of applying for VR (Table 4). Thus, approximately, one in 10 non-ssa VR applicants became disability beneficiaries within a relatively short time. Disability benefit receipt increased steadily from 24 months to 48 months for each agency. Agencies had sizeable variation in the percentage of non-ssa VR youth applicants who received SSA benefits within 48 months of application, from 4 percent (South Carolina) to 21 percent (Washington State). Five agencies had values at or above 18 percent, which means about one of every five non-ssa VR youth applicants received SSA benefits within 48 months of applying for VR. Three of these agencies (Connecticut, Maine, and Rhode Island) are located in the Northeast. Additionally, three of the states with the highest rates of SSA benefit receipt after VR application were in OOS and had waiting lists for services for the analysis period. As a result of being in OOS, these states were required to serve those with the most severe disabilities, which includes those already receiving SSA benefits and those most likely to meet SSA medical criteria for benefits. On the other end of the spectrum, seven agencies had rates below 6 percent, four of which (Alabama, Mississippi, South Carolina, and West Virginia) are in the South. D. How Do the Statistics for VR Youth with and without SSA Benefits Compare with Each Other and with State Characteristics? Correlations across the six SSA transition ratios indicate the extent to which the statistics are related to each other, as well as to the non-ssa transition ratios and selected state and agency characteristics (Table 5). Three key themes emerge. First, the SSA service-to-applicant, employment-to-service, and employment-to applicant ratios were highly and positively correlated with the same ratios for non-ssa VR applicants, suggesting that the patterns of processes and outcomes are similar for all VR applicants, even if the values of the ratios differ. Second, the proportion of SSA VR applicants with benefit suspension due to work was positively correlated with several factors, most strongly with the SSA employment-to-service ratio and the VR grant allotment per working-age person with disabilities. As might be expected, agencies where more SSA VR applicants exit VR services with a positive employment outcome are more likely to have higher ratios of SSA VR youth with at least one month off of benefits due to work. Available resources, in the form of the VR grant allotment per person with disability, appear to also be influential in this outcome. In addition, three factors (the number and percentage of transition-age youth in the state and the annual unemployment rate) may provide some constraints on the proportion of SSA VR youth who have benefit cessation. 18